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Pulmonary > PATHOPHYS: URTIs > Flashcards

PATHOPHYS: URTIs Flashcards

1
Q

What is otitis media?

A

Infection of the middle ear caused by viruses or bacteria.

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2
Q

What are the important causative pathogens of otitismedia?

A 
Strep pneumoniae
H. Flu
Moraxella catarrhalis
RSV
Coronavirus
Rhinovirus
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3
Q

What is the most common predisposing factor to otitis media?

A

seasonal allergic rhinitis

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4
Q

Who gets otitis media?

A

children under 3

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5
Q

Why are young children most likely to develop otitis media?

A

they have small opening of the eustachian tube that is easily blocked by inflammation caused by viral infection/allergic response (which will cause fluid retention and infection in the middle ear)

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6
Q

What are the physical findings of otitis media?

A

erythematous tympanic membrane with loss of light reflex and decreased mobility (sometimes tympanic membrane may bulge and rupture)

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7
Q

HOw do you treat otitis media?

A

amoxicillin

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8
Q

What is sinusitis?

A

inflammation of the paranasal sinuses

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9
Q

What causes sinusitis?

A

impaired mucociliary clearance caused by viral infection or allergic rhinitis can obstruct the orifice of the sinus leading to mucus accumulation and bacterial overgrowth

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10
Q

Which sinuses does sinusitis typically involve?

A

maxillary sinus (ostium of sinus is superior so mucus drainage has to go against gravity)

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11
Q

What are symptoms of sinusitis?

A

Purulent nasal discharge
Nasal congestion
Facial/sinus pain
Fever

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12
Q

What are the important pathogens of sinusitis?

A

S. pneumoniae
H. flu
M. Catarrhalis

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13
Q

What is the treatment for sinusitis?

A

if symptoms last over ten-fourteen days, give amoxicillin (or augmentin if resistant)

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14
Q

What is pharyngitis?

A

inflammation of the throat caused primarily by viruses (ex. adenovirus)

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15
Q

What bacteria are involved in pharyngitis?

A 
Strep pyogenes (GAS)
Neisseria gonorrhoeae (sexually)
Corynebacterium diptheriae (where no diptheria vaccine is given)
Mycoplasma, chlamydia, etc.
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16
Q

What are the symptoms/signs of pharyngitis?

A 
sore throat that is worse when swallowing
Fever
Inflamed pharynx, tonsils, and palate
Greyish exudate on tonsils
Lymphadenopathy (tender)
Petetchiae on palate
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17
Q

How do you diagnose a GAS pharyngitis?

A

rapid antigen detection tests

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18
Q

How do you treat GAS pharyngitis?

A

penicillin G, penicillin V, or amoxicillin

Erythromycin or cephalexin if penicillin allergy

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19
Q

True or false: most sore throats are bacterial.

A

FALSE: most are viral, so prescribing antibiotics is a major problem!

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20
Q

What is the common cold?

A

viral infection of the URI

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21
Q

What types of viruses cause the common cold?

A

nonenveloped viruses like rhinovirus and coronavirus

22
Q

What may help to reduce symptoms of the common cold?

A

Zinc acetate in doses greater than 75 mg/day

23
Q

What is croup?

A

inflammation of the larynx, trachea, and large bronchi

24
Q

What is the key finding of croup?

A

inspiratory stridor

Barking cough

25
Q

What is the most common cause of croup?

A

parainfluenza virus
RSV
Flu

26
Q

What radiologic manifestation may indicate croup?

A

“steeple sign” which is subglottic tracheal narrowing

27
Q

What is the treatment of the croup?

A

corticosteroids (ex. dexmethasone)

with or without epinephrine

28
Q

What is laryngitis?

A

inflammation of the vocal cords of the larynx

29
Q

What are the common clinical manifestations of laryngitis?

A

hoarseness

aphonia

30
Q

What is the most common cause of laryngitis (top 2)?

A

parainfluenza virus

rhinovirus

31
Q

How do you treat laryngitis?

A

hydration

voice rest

32
Q

What is epiglottitis?

A

inflammation of the epiglottis

33
Q

What are the clinical manifestations of epiglottitis?

A 
rapidly worsening sore throat
odynophagia (pain swallowing)
dysphagia (difficulty swallowing)
muffled voice
MEDICAL EMERGENCY for young children because may cause airway obstruction
34
Q

What is the most common cause of epiglottitis?

A

H. influenzae type B

35
Q

What is seen on indirect laryngoscopy of a patient with epiglottitis?

A

swollen, cherry red epiglottis

36
Q

What radiologic finding may be indicative of epiglottitis?

A

“thumb” sign (enlarged epiglottis)

37
Q

What is the treatment for epiglottitis?

A

IV ceftriaxone

maybe corticosteroids to reduce inflammation

38
Q

Is someone with a cold caused by rhinovirus at risk for pneumonia?

A

no Rhinovirus does NOT cause LRTI

39
Q

Is someone with a cold caused by coronavirus at risk for pneumonia?

A

NO coronavirus does not cause LRTI (unless it is SARS or MERS)

40
Q

Can rhinovirus survive in the GI tract?

A

NO–they are acid labile (killed by gastric acid when swallowed)

41
Q

Can coronavirus survive int he GI tract?

A

yes!

42
Q

Why do we not have a vaccine for rhinovirus?

A

because there are too many serotypes (over 100)

43
Q

How many serotypes are there for strep pneumo?

A

93

44
Q

What is the major pathogenesis of rhinovirus?

A

Chemical mediators of inflammation cause congestion and mucous secretion (LOOK BACK)

45
Q

What is a common complication of URTI?

A

acute bacterial sinusitis

46
Q

What is second line treatment for otitis media?

A

Augmentin

47
Q

How long do children get observed?

A

48-72 hours

48
Q

What is the pathogenesis of diptheria?

A

A-B toxin blocks protein synthesis by inactivating EF-2 by ADP ribosylation,resulting in decreased protein synthesis

49
Q

What is the pathogenesis for H. flu?

A

Produces IgA protease facilitating attachment to the mucosa, also is encapsulated and evades phagocytosis.

50
Q

What is the receptor for rhinovirus?

A

ICAM-1

51
Q

What is the most typical epidemiology for epiglottitis patient?

A

Urbanmale in his 40s with rapid onset of sore throat, muffled voice, and odynophagia/dysphagia

52
Q

Why are ear infections more common in children?

A

Ear infections are more common in children because their Eustachian tubes are shorter, narrower, and more horizontal than in adults.

Pulmonary (34 decks)

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